The book is organized around five W,s. 1. What: What are we about organizationally? What is our overarching culture as expressed in goals, leadership, and approach to quality and safety? 2. Why: As individuals why are we here? What is our commitment, ownership, accountability, and decision-making? The decision vortex is a balance between the information algorithm, emotional intelligence and intuition. 3. What: What do we know about our organization? How we get data and how we interpret it. 4. Why: The data is only a number, why does it occur and what analysis is necessary to make it useful. 5. What: Once we have an understanding of the Why, what can we do about it?